Epidural injections: Past, present and future

Abstract

In the past, if someone had pain and a "defect" was noted on the myelogram or CT, surgery was immediately warranted. During this era, neural compression was considered to be the sole reason for all spinal pain. The surgical community firmly believed in the presence of a concrete-structural alteration to explain the pain and spinal arthrodesis was introduced. Over time, it became obvious that many patients did not improve after surgical interventions. Epidural injections were performed, formerly without fluoroscopic localization, and then with precise targeting. The spine care clinicians incorporated mediation of inflammation and neuromodulation as pathways to achieve pain control in order to pave the way for functional restoration. Epiduroscopy is presented as the most recent, complete and effective means for treating persistent low-back pain. © 2011 Springer-Verlag/Wien.